well, I understand that Nifedipine is mainly an arteriolar vasodilator, this drug has minimal effect on cardiac conduction or heart rate, but nevertheless the vasodilation effect of nifedipine is useful in the treatment of variant angina caused by spontaneous coronary spasm

Ah, I know the steal syndrome well. It is the same concept behind a persantine stress test. If you have blockages in one or more of your coronary arteries, there is impedence of flow. That much is easy. Now, add a vasodilator which acts mostly on the arteries (nifedipine or persantine). The healthy vessels will dilate significantly, and the diseased/blocked arteries won't dilate much at all. So blood goes through the path of least resistance. Blood flow through the relatively healthy arteries increases, this "steals" blood away from the diseased arteries, and you actually get less flow to the tissue downstream. Does that make sense? G

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